Clinical analysis of 118 cases of aldosterone producing adrenal cortical neoplasms
10.3760/cma.j.issn.1000-6702.2009.08.013
- VernacularTitle:腺瘤型原发性醛固酮增多症临床延迟诊断原因分析
- Author:
Jiangang GAO
;
Hanzhong LI
- Publication Type:Journal Article
- Keywords:
Adenoma;
Hyperaldosteronism;
Diagnostic errors
- From:
Chinese Journal of Urology
2009;30(8):539-542
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the diagnosis and treatment of aldosterone producing adreral cortical neoplasms,and analyse the reason of misdiagnosis. Methods From 1998 to 2005,118 patients with aldosterone producing adrenal cortical neoplasms were diagnosed and treated.of these patients,age of onset was(37.3±8.4)years,age of diagnosis was(44.54-10.1)years.The age of 46 EH patients in the control group was(45.6±14.2)years.The information of the history,plasma/urine potassium,the ratio of night/day urine volume,PRA,PAC,ratio of erect position ALD/renin were recorded and analyzed.The diagnosis was all confirmed by surgery and pathological studies. Results It was found that plasma potassium(2.6±0.7)mmol/L;urine potassium(56.0±31.2)mmol/24 h,PRA(2.1±1.2)μg·L-1·h-1,PAC(840.5±527.1)pmol/L,ratio of erect position ALD/renin (254.24±153.4)in APA group.And plasma potassium concentration was(3.9±0.5)mmol/L,urine potassium(13.0±5.3)mmol/24 h,PRA(9.34±3.4)μg·L-1·h-1,PAC(393.94±216.4)pmol/L,ratio of erect position ALD/renin(23.94±15.5)in EH terms.There were significant differences between APA and EH groups(P<0.05).Average time of misdiagnosis in APA was(7.2±6.2)years,7 cases (6%)had complication before diagnosis.In all the patients,serum potassium level elevated to normalange within 1 month postoperatively.In 100 cases out of 118,the blood pressure dropped to normal range within three months after surgery.There were significant differences of the age of onset[(34.5 ±9.1)versus(48.5±12.1)years],persistence time of hypertension[(6.2±5.2)versus(8.85±6.6)years] and the ratio of night/day urine volume(0.9±0.7)versus(1.3±0.6),between normal and high postoperative blood pressure patients(P
